Protein diet - controlled - 40g
This document is part of the ACI Diet Specifications for Adult Inpatients. It is not to be used for patient education.
To limit protein intake to 40g per day.
At least half the protein should be from foods with high biological value (such as meat, eggs and dairy), with grains, vegetables and fruit providing the rest.
Acute or chronic kidney disease with a reduced glomerular filtration rate.
This diet is not nutritionally adequate in protein and is likely to be inadequate in thiamin, riboflavin, niacin, folate, iron and calcium. Protein restriction may lead to inadequate energy intake.
Must only be used when ordered by a physician and under the supervision of a dietitian.
In renal failure, sodium, potassium, phosphate and fluid restrictions may be combined with this diet. Long-term use of low-protein and very-low-protein diets can lead to patient decline in nutritional status, with decreases in serum albumin, serum transferrin, body weight, per cent body fat, arm muscle area and urine creatinine excretion.
Suitable for use in paediatrics when combined with an age-appropriate diet.
Suggested meal structure
- Breakfast: <10g
- Morning tea: <2g
- Lunch: <10g
- Afternoon tea: <2g
- Dinner: <10g
- Supper: <5g
Main hot dish, or salad or sandwich – limit to one meal only per day
Specific menu planning guidelines
|Hot main dishes||<10g protein per serve (i.e. normally a half serve)||-|
|Sauces, gravies||All (at 30g serve)||-|
|Starchy vegetables / pasta / rice||All||-|
|Soups||All <2g protein per serve||-|
|Sandwiches||All <10g protein per serve||-|
|Salads, dressings||All <10g protein per serve||-|
|Hot breakfast choices||Egg – one only||All others|
|Yoghurt||Yoghurt <3g protein per serve||-|
|Desserts||All <3g protein per serve||-|
|Milk and cheese|
Whole or skim milk – limit to 250mL per day
Cheese as allowed in salad or sandwich limits
|High-protein milk (e.g. Shape™)|
|Beverages||Tea, coffee, soft drinks, cordial||Milk|
|Biscuits||Low-protein biscuits only||-|
- Food Standards Australia New Zealand. NUTTAB Online searchable database: foods that contain protein.
- Dietitians Association of Australia. Nutrition manual. 8th ed. Canberra: DAA; 2009. 3
- American Dietetic Association. Nutrition care manual. Chicago: ADA; 2009. [accessed 26 April 2010];
- Fouque D, Laville M. Low protein diets for chronic kidney disease in non diabetic adults. Cochrane Database Sys Rev 2009;(3):CD001892.
- Dietitians Association of Australia: Australia and New Zealand Renal Guidelines Taskforce. Evidence based practice guidelines for the nutritional management of chronic kidney disease. Nutr Diet 2006;63 Suppl 2:S35-45.
- Maher AK, editor; Iowa Dietetic Association. Simplified diet manual. 10th ed. Ames: Blackwell; 2007.
- Caring for Australians with Renal Impairment. CARI guidelines: protein in pre-dialysis patients. 2004.
- Kopple JD, Levey AS, Greene T, Chumlea WC, Gassman JJ, Hollinger DL et al. Effect of dietary protein restriction on nutritional status in the Modification of Diet in Renal Disease Study. Kidney Int 1997;52:778-91.